Advanced medical technologies used in monitoring and therapy for diabetes - review work

Throughout the years monitoring and therapy of diabetes was significantly changing. Undoubtedly, a definite improvement of applied technologies not only increased the average life expectancy of diabetic patients but also influenced their comfort. The purpose of the study was to present the history of methods diagnosis and treatment of diabetes. Additionally, promising modern medical technologies were reviewed. Nanotechnology, modern robots and transplants of pancreatic islets are currently under experiments showing satisfactory results. These technologies enable monitoring of glucose level, prevent hypoglycemia and sustain normoglycemia. Moreover, surgical attempt involving transplantation give a chance to counter the complications followed by diabetes development

Microwave Noninvasive Blood Glucose Monitoring Sensor: Penetration Depth and Sensitivity Analysis

Previously reported clinical performances of microwave noninvasive blood glucose monitoring sensor look promising. It is clear that dielectric properties are changing when the food intake takes place, but the exact physiological mechanism is not clear. In an attempt to figure out the physiological mechanism of microwave noninvasive blood glucose monitoring sensor, this paper presents a series of studies to find out a) the penetration depth of the microwave resonator-based sensor and b) the effect of permittivity variation of human tissues on the microwave resonator parameters

Tehnološka potpora prevenciji i liječenju šećerne bolesti

Prikazan je pregled suvremenih informacijskih i komunikacijskih tehnologija (IKT) koje se primjenjuju za dijagnostiku, liječenje i prevenciju šećerne bolesti kao i rezultati projekta diabICT tijekom kojeg je razvijena tehnološka e-platforma za liječenje i kontrolu šećerne bolesti. Osjetila (senzori) za praćenje fizioloških veličina i fizičke aktivnosti osoba danas se zbog svojih malih dimenzija jednostavno ugrađuju u predmete za svakodnevnu uporabu pa su općenito dobro prihvaćeni od pacijenata. Generirani podatci šalju se u stvarnom vremenu na odgovarajuću platformu gdje su dostupni za trenutni ili naknadni pregled i pohranu. Pri tome se za prijenos podataka sve češće koriste mobilne komunikacije kao dio sustava m-zdravlja. Zajedno s podacima iz osobnih zdravstvenih zapisa, tvore velike skupine podataka koje se odgovarajućim metodama analize koriste za praćenje napretka bolesti, ali i za izgradnju modela koji onda omogućuje predviđanje tijeka bolesti za pojedince i za skupine. Za uspješnost primjene e-platforme važna je interoperabilnost koja omogućuje unos svih relevantnih podataka i priključivanje dodatnih osjetila za automatski unos podataka u platformu kao i izvoz i razmjenu podataka u različitim sustavima e-zdravstva. Druga važna značajka e-platformi jest skalabilnost s obzirom na to da je prema statističkim podatcima globalno i nezavisno od stupnja razvijenosti zemalja, šećerna bolest prisutna u oko 10% populacije

Diabetes Monitoring System

This is the author accepted manuscript. The final version is available from CRC Press via the DOI in this recordThis chapter reviews the current technologies for monitoring and intervention of diabetes. Especially various blood glucose concentration estimation, online signal monitoring and adaptive control mechanisms are discussed. Recent research has proposed many control engineering approaches for Type 1 diabetes and many algorithms of artificial pancreas have been proposed. This book chapter reviews the current state of the art and industrial standards on diabetes monitoring and control

RFFE – Random Forest Fuzzy Entropy for the classification of Diabetes Mellitus

Diabetes is a category of metabolic disease commonly known as a chronic illness. It causes the body to generate less insulin and raises blood sugar levels, leading to various issues and disrupting the functioning of organs, including the retinal, kidney and nerves. To prevent this, people with chronic illnesses require lifetime access to treatment. As a result, early diabetes detection is essential and might save many lives. Diagnosis of people at high risk of developing diabetes is utilized for preventing the disease in various aspects. This article presents a chronic illness prediction prototype based on a person's risk feature data to provide an early prediction for diabetes with Fuzzy Entropy random vectors that regulate the development of each tree in the Random Forest. The proposed prototype consists of data imputation, data sampling, feature selection, and various techniques to predict the disease, such as Fuzzy Entropy, Synthetic Minority Oversampling Technique (SMOTE), Convolutional Neural Network (CNN) with Stochastic Gradient Descent with Momentum (SGDM), Support Vector Machines (SVM), Classification and Regression Tree (CART), K-Nearest Neighbor (KNN), and Naïve Bayes (NB). This study uses the existing Pima Indian Diabetes (PID) dataset for diabetic disease prediction. The predictions' true/false positive/negative rate is investigated using the confusion matrix and the receiver operating characteristic area under the curve (ROCAUC). Findings on a PID dataset are compared with machine learning algorithms revealing that the proposed Random Forest Fuzzy Entropy (RFFE) is a valuable approach for diabetes prediction, with an accuracy of 98 percent

Modelling and validation of the influence of the menstrual cycle on the glucose-insulin system in healthy individuals

[EN] Different studies have shown that insulin sensitivity fluctuates during the luteal and follicular phase of the menstrual cycle and can generate alterations in the behavior of the glucose level. Knowing the correlation between the menstrual cycle phases and the insulin resistance is a main goal looking forward to improving life quality in diabetic patients. In this research proposes a modification to the mathematical model developed by Dalla Man et al. (Dalla Man, C., Rizza, R. A., & Cobelli, C., 2007) to include the different stages of the menstrual cycle on the behavior of the blood glucose level, taking into account changes in insulin sensitivity and the baseline blood glucose. To verify the behavior of the glucose level during the menstrual cycle described in the literature, a glucose tolerance test was performed in a healthy regularly menstruating subject and compared with in-vitro simulation results. The results allowed us to observe the behavior described in the proposed model by relating the different phases of the menstrual cycle and insulin resistance.[ES] Diversos estudios han demostrado que la sensibilidad a la insulina presenta fluctuaciones durante la fase lútea y folicular del ciclo menstrual que pueden generar alteraciones en el comportamiento del nivel de glucosa. Diversos estudios han demostrado que la sensibilidad a la insulina presenta fluctuaciones durante la fase lútea y folicular del ciclo menstrual que pueden generar alteraciones en el comportamiento del nivel de glucosa. Conocer la relación entre las fases del ciclo menstrual y la resistencia a la insulina es un objetivo de salud personalizada, enfocada a la mejora de la calidad de vida. En esta investigación se propone una modificación al modelo matemático desarrollado por Dalla Man et al. (Dalla Man, C., Rizza, R. A., & Cobelli, C., 2007) para incluir las diferentes etapas del ciclo menstrual sobre el comportamiento del nivel de glucosa en la sangre, teniendo en cuenta cambios en la sensibilidad a la insulina y el valor basal de glucosa en la sangre. Para comprobar el comportamiento del nivel de glucosa durante el ciclo menstrual descrito en la literatura se realizó una prueba de tolerancia a la glucosa en una individua sana regularmente menstruante y se comparó con resultados de simulación in-vitro. Los resultados permiten observar comportamiento descrito en el modelo propuesto al relacionar las diferentes fases del ciclo menstrual y la resistencia a la insulina.Manrique-Córdoba, J.; Romero-Ante, JD.; Vicente Samper, JM.; Sabater-Navarro, JM. (2023). Modelado de la influencia del ciclo menstrual en el sistema glucosa-insulina en individuas sanas. Revista Iberoamericana de Automática e Informática industrial. 21(1):81-89. https://doi.org/10.4995/riai.2023.18533818921

Efeito da administração intracerebroventricular de metilglioxal sobre a função astroglial no hipocampo e barreira hematoencefálica

O metilglioxal (MG) é um composto dicarbonil, formado a partir de fontes exógenas e endógenas. A taxa de formação do composto depende do metabolismo e tipo celular e pelas condições fisiológicas, sendo, endogenamente, a via glicolítica, a mais importante fonte de produção. Níveis elevados de glicose estão relacionados ao acúmulo de MG no plasma e no líquido cefalorraquidiano (LCR), em doenças como o diabetes mellitus (DM) e a doença de Alzheimer (DA). A alta reatividade do MG leva a modificações de proteínas e outras biomoléculas, gerando produtos finais de glicação avançada (AGEs), apontados como mediadores nessas desordens neurodegenerativas. Além da glicação, outros efeitos resultantes de altos níveis de MG no sistema nervoso central (SNC) são envolvidas na direta modulação da neurotransmissão GABAérgica e glutamatérgica, com evidências sugerindo que os efeitos do MG podem ser relacionados a mudanças comportamentais e disfunção glial. No SNC, os astrócitos são mais suscetíveis ao dano para o estresse dicarbonílico, embora essas células apresentam um sistema glioxalase mais eficiente quando comparado com neurônios, sugerindo um aumento no dano funcional neuronal sob complicações diabéticas e em desordens neurodegenerativas. Em vista disso, o objetivo deste estudo foi avaliar a influência de altas concentrações de MG no SNC. Foi avaliado como a administração intracerebroventricular (ICV) de MG (3 μmol/μL) causa mudanças comportamentais como o declínio cognitivo e ansiedade bem como alterações bioquímicas no hipocampo, soro e LCR. Além disso, nós investigamos a integridade da barreira hematoencefálica (BHE) relacionada às funções astrocitárias no hipocampo.MG induziu, 12 h após a sua administração, um decréscimo na atividade locomotora no campo aberto e efeitos ansiolíticos nos ratos submetidos ao Teste do labirinto em cruz elevado. Subsequentemente, 36 h após a cirurgia ICV, a injeção de MG também induziu prejuízo cognitivo nas memórias de curto e longo prazo, avaliado pela tarefa do reconhecimento de objetos. Foi avaliado também a memória espacial de curto prazo, avaliada pelo teste do Y-maze. Setenta e duas horas após infusão do MG, a captação de glutamato, a atividade da glutamina sintetase e os níveis da glutationa foram diminuídos em relação ao grupo SHAM. Interessantemente, os níveis da proteína astrocitária, S100B, estavam aumentados no LCR, o que foi acompanhado pelo decréscimo na expressão do RNAm da S100B hipocampal, mas não nos níveis da proteína. Não houve mudanças no conteúdo do receptor para AGEs (RAGE). Além disso, nós observamos uma perda na integridade da BHE, avaliada pela entrada do corante azul de Evans blue no tecido cerebral e de albumina no LCR. Além destas alterações, houve decréscimo nos níveis da aquaporina-4 e conexina-43 no tecido hipocampal. A expressão gênica (RNAm) de dois importantes fatores de transcrição da resposta antioxidante, NfkB e Nrf2, não foram alterados no hipocampo. Contudo, a hemeoxigenase-1 (HO-1) foi aumentada no grupo tratado com o MG. Em conjunto, esses dados corroboram com a ideia de que os astrócitos, as principais células responsáveis pelo clearance do MG, são alvos na toxicidade do MG e que a disfunção da BHE induzida por este composto podem contribuir nas alterações cognitivas e comportamentais observadas nesses animais. Isso nos ajuda a melhorar nosso entendimento de como produtos derivados do metabolismo da glicose podem induzir a disfunções cognitivas observadas em pacientes diabéticos bem como em outras condições neurodegenerativas, e uma melhor definição do papel dos astrócitos nas doenças e terapêutica.Methylglyoxal (MG) is a dicarbonyl compound, formed from exogenous and endogenous sources. The formation rate of compound depends on metabolism and cell type and physiological conditions, which the glycolytic pathway represents the most important endogenous production source. Elevated blood glucose levels are related to MG accumulation in plasma and cerebrospinal fluid (CSF) diabetes mellitus and Alzheimer’s disease (AD). The high reactivity of MG leads to modification of proteins and other biomolecules, generating advanced glycation end products (AGEs) appointed as mediators in these neurodegenerative diseases. In addition to protein glycation, other effects resulting from high levels of MG in the central nervous system (CNS) may involve the direct modulation of GABAergic and glutamatergic neurotransmission, with evidence suggesting that the effects of MG may be related to behavioral changes and glial dysfunction. In the CNS, astrocytes are more susceptible to damage of dicarbonyl stress, although they have an improved glyoxalase system when compared to neurons, suggesting an increased neuronal functional damage under diabetic complications and neurodegenerative disorders. In view of this, the aim of this study was evaluating the direct influence of high concentration of MG in the CNS. It was evaluated how intracerebroventricular (ICV) administration (3 μmol/μL) cause behavioral changes, as cognitive decline and anxiety as well as biochemical alterations in the hippocampus, serum and CSF. Furthermore, we investigated the blood-brain barrier (BBB) integrity related to astrocytic functions in the hippocampus. MG induced, 12h after injection, a decrease in locomotor activity in the Open field (OF) and anxiolytic effects in rats submitted to elevated plus-maze (EPM). Subsequently, at 36 h after ICV surgery, MG injection also induced cognitive impairment in both short and long-term memory, as evaluated by novel object recognition tasks, and in short-term spatial memory, as evaluated by the Y-maze test. 72h after infusion of MG, hippocampal glutamate uptake decreased and glutamine synthetase activity and glutathione levels diminished. Interestingly, the astrocytic protein, S100B, was increased in the cerebrospinal fluid, accompanied by decreased hippocampal S100B mRNA expression, without any change in protein content and hippocampal contents of RAGE. In addition, we observed a loss of BBB integrity, as assessed by the entry of Evans dye into brain tissue and albumin in the CSF, as well as a decrease of aquaporin-4 and connexin-43 in hippocampal tissue. The mRNA expressions of two important transcription factors of antioxidant response - NfkB and Nrf2, were not changed. However, hemeoxigenase-1 was upregulated in MG-treated group. Taken together, this data corroborates with the idea that astrocytes, the main cells responsible for MG clearance, are targets of MG toxicity and that BBB dysfunction induced by this compound may contribute to behavioral and cognitive alterations observed in these animals. It helps us an improve our understanding of how this product of glucose metabolism can induce the brain dysfunction observed in diabetic patients, as well as in other neurodegenerative conditions, and further defines the role of astrocytes in disease and therapeutics